Drug and nutrient interactions Flashcards
Birth control/contraceptives
depletion of b vitamins
contrac w/estrogen (folate B9) , vitamin A, Vitamin C
Estrogen : accelerate calcium and magnesium deposition from bone
cholesterol, Heart
ACE inhibitors (hypertension)
-Inhibits iron
-depletes zinc
-hold potassium (Hyperkalemia)
Amlodipine: Calcium channel blockers: (Hypertension)
- watch grapefruit and pomegranate (CYP450, CYP3A4) : increases level of drug.
ART: antiretroviral
St. Johns wart, and garlic (decreases efficacy)
Atorvastatin ( cholesterol)
-depletes coQ10, Metformin, B12, Vitamin D
-COmpetes with PPI
-grapefruit: increases serum, induces CYP3A4
-St Johns Wart: increases LDL
-Red yeast rice: similar to statin
-HMG-C0A reducates (Lipitor)
-inhibits CoQ10
Anticoagulants (warfarin, coumadin)
-competes with vitamin K
-also affected by high doses vitamin E
-Gingko Biloba : potentiates action of anticoagulants.
-Black Current : ANtithrombonic
Interfere with D activation and ostepblast function
Beta Blockers: (antihypertensive)
-coQ10, melatonin
-chelates/absorption of calcium
Hypocholesterolemics :
Lower absorption of vitamin B12, binds bile acid, cholesterol, bile salts, nutrients, lower digestion/absorption of fatty acid, fat sol, vitamins, iron, b-carotene.
0clofibrate: B12, Vitamin A, D, E
-Colestipol: binds promotes bile acid excretion, lower fatty acid/fat-sol vitamin absorption.
Antihypertensives (methyldopa)
INHIBIT ENZ REQB6 , inhibits coQ10, grapefruit increases
Immune, cancer
anthracyclines/chemo
-CoQ10
methotrexate (cancer, RA)
Folate antagonist, B12, calcium,
anitbiotics (tetracylcines, amoxicillin
magnesium, vitamin K
Iron, b vitamins, k, calcium, zinc, magnesium, probiotics.
anticonvulsants (antiseizures)
impairs bioavailability of vitamin D, Folate, B7, B12, vitamin C,
lowers ca absorption
St johns wort
antitubercular
inhibits conversion of tryptophan>niacin
antimicrobial
inhibits absorption of FA< AA< Ca, Na, K, folate, vitamin B12 , iron
inhibits mucosal uptale of folate.
antiinflammatory drugs (aspirin) NSAIDS
iron
melatonin, zinc,
antiinflammatory (folate)
glucocorticoids: medicines that fight inflammation
inhibit calcium and folate
accelerate bone mineralization
corticosteroids (hydrocortisone)
imprairs vitamin D bioavalability
folate
analgesic acetaminophen(tylenol)
alcohol,
N-acetylcysteine is used to combat tylenol/ carbon monoxide posioning
Gastrointestinal/Antacids
PPI (reduces gastric acid secretion leading to B12 deficiency)
-B12, folate (after 3 years)
Calcium, iron zinc, mg, b1
Long term use : IBS, osteoporosis, SIBO
p. anemia
H.Pulori
Vitamin A/E/D/K (fat malabsorption)
H2blockers (ranitidine/zantac)
calcium weakens bones
folate
inhibits vitamin D absorption
Anti-gout
induces b12 malabsorption
Antidepressants
MAO inhibitors
interacts with Tyramine
(anchovies, chocolate, meat extracts, sour cream, raspberry, fermented products, aged cheeses, soy, wine,
-increases risk for hypertension
vasopressor agents in foods (avoid w MAO)
Antipsychotics
coQ10
Antidepressents (tricyclic)
dry mouth and tooth decay
CoQ10
SSRI
melatonin
folate
avoid: tryptophan/5-HTP, SAM-e, Kava Kava, SJW
Barbiturates (sedatives, sleep )
impairs vitamin D
folate
Diuretics
calcium, zinc, folic acid
inhibits potassium (K)
Also Thiamin B1, Mg
potassium repletion
inhibits B12 absorptiom
laxatives
decreases: ca, K, b-carotene , vitamin A, Vitamin K
decreases vitamin D
albuterol
calcium, mg, potassium
hypoglycemics (metformin)
B12, Folic acid (b9)
liver
levothyroxine
calcium/coffee: decreases absorption
vitamin C: increases absorption
grapefruit: decreases absirption
